Can a spreader graft be used to raise the bridge, or only widen it in rhinoplasty?

Question

I've undergone internal nasal valve collapse. Can a spreader graft be used to raise upper lateral cartilages, or can it only widen them? How can upper lateral cartilages be respunded in revision rhinoplasty if a nasal bridge has been lowered? How does this account for someone that already as a wide, shortened, crooked nose?

Andrew Miller, MD · Answer

To answer your question, yes, a spreader graft can be used to raise the upper lateral cartilage, and that is its primary function. If the upper lateral cartilage collapses after primary rhinoplasty, the spreader graft will raise it back up to the proper position. It doesn't necessarily have to widen the nose. It is important to see a rhinoplasty specialist in person so he/she can examine you and determine the best course of action.

Jeffrey Rockmore, MD · Answer

Thank you for an excellent question.  Spreader grafts are pieces of cartilage placed between the upper lateral cartilage and the dorsal cartilage.  After a rhinoplasty, the angle between these two structures can become too acute, which creates a narrow angle and reduced airflow.  By placing a spreader graft, the angle is slightly opened, which creates more room for air passage.  There are other uses for spreader grafts as well.  They can be used as struts to straighten a crooked nose, or lengthen an overly short nose.  While they can add a small amount of dorsal height,  there are other types of grafts and implants that work better for this need.I would suggest consulting with a plastic surgeon with significant rhinoplasty experience.  Spreader grafts and other types of grafts in the nose require finesse and experience to get the best results.Best of luck with your nose.Jeff Rockmore

Kenneth R. Francis, MD, FACS · Answer

Dear Little Miss,In a word, yes, spreader grafts can be used to augment the dorsum of the nose.  They are not generally considered the best way to do that, depending on where the elevation is needed.  Seek consultation with an American Board of Plastic Surgery board certified plastic surgeon for options.  Good luck!

Steven Wallach, MD · Answer

Graft in general can be used in many different ways.  A spreader graft is used to increase the middle vault angle to aid in breathing.  It can also help straighten the middle vault.

William Portuese, MD · Answer

A spreader graft placement can be used on one or both sides of the nose to widen it and open up the nasal valve. They are performed when the upper lateral cartilages are concave and need widening. A dorsal onlay cartilage graft is used to build up the bridge height. For more information and many examples, please see the link and video below

Can a spreader graft be used to raise the bridge, or only widen it in rhinoplasty?

Answers (5)